Emotional well-being in people with sight loss: Lessons from the grey literature

Literature that is not peer-reviewed and distributed through a publisher is known as ‘grey’. As it is used to inform policy and practice we reviewed the grey literature concerning emotional well-being in people with sight loss. We consulted and searched the websites of UK voluntary organizations, and scanned reference lists of previous reviews for reports available from 2001 to 2008. We summarized 24 studies in two sections: observations that assessed psychosocial well-being or demand for support services (n = 15); and evaluations of interventions that aimed to improve emotional well-being (n = 9). Observations showed that people with sight loss can report low emotional well-being, but their statistical and clinical significance requires testing. Interventions showed promise for counselling but also require further evaluation. We encourage service providers and researchers to collaborate and produce high quality research to more persuasively inform policy and practice

Counselling for people with sight loss in the UK: The need for provision and the need for evidence

For adults of any age the diagnosis of a visual impairment can be traumatic, and timely referral to informal peer support and/or professional counselling may be both beneficial and appropriate. It is estimated that 45/113 (40%) of UK voluntary organisations for people with sight loss provide professional counselling (n=17) or ‘informal support’ (n=28), such as peer support groups, telephone helplines and befriending.1 However, what is the evidence that these services help people adjust emotionally to their acquired vision loss and the consequences that flow from this? During the spring/summer of 2008, we conducted a follow-up to the scoping survey reported earlier1 to assess the evidence for effectiveness of professional counselling services for people with acquired sight loss. We contacted the 17 counselling services previously identified by Rees1 and further services via Vision 2020 UK,

Properties of the Fixed Point Lattice Dirac Operator in the Schwinger Model

We present a numerical study of the properties of the Fixed Point lattice Dirac operator in the Schwinger model. We verify the theoretical bounds on the spectrum, the existence of exact zero modes with definite chirality, and the Index Theorem. We show by explicit computation that it is possible to find an accurate approximation to the Fixed Point Dirac operator containing only very local couplings.Comment: 38 pages, LaTeX, 3 figures, uses style [epsfig], a few comments and relevant references adde

Chemostratigraphy of Neoproterozoic carbonates: implications for 'blind dating'

The delta C-13(carb) and Sr-87/Sr-86 secular variations in Neoproteozoic seawater have been used for the purpose of 'isotope stratigraphy' but there are a number of problems that can preclude its routine use. In particular, it cannot be used with confidence for 'blind dating'. The compilation of isotopic data on carbonate rocks reveals a high level of inconsistency between various carbon isotope age curves constructed for Neoproteozoic seawater, caused by a relatively high frequency of both global and local delta C-13(carb) fluctuations combined with few reliable age determinations. Further complication is caused by the unresolved problem as to whether two or four glaciations, and associated negative delta C-13(carb) excursions, can be reliably documented. Carbon isotope stratigraphy cannot be used alone for geological correlation and 'blind dating'. Strontium isotope stratigraphy is a more reliable and precise tool for stratigraphic correlations and indirect age determinations. Combining strontium and carbon isotope stratigraphy, several discrete ages within the 590-544 Myr interval, and two age-groups at 660-610 and 740-690 Myr can be resolved

The role of subjective social status in living well for carers of people with dementia: findings from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) programme

YesWe investigated how carers of people with dementia evaluate their standing in their community and wider society, and if this is related to ‘living well’. We used baseline data from the Improving the experience of Dementia and Enhancing Active Life programme and found that carers rated their standing in society higher than in their local community. Higher evaluations of both were associated with enhanced life satisfaction, well-being and quality of life. Initiatives that increase support or engagement in the community or wider society may help to increase carers’ perceptions of their social status, enhancing their ability to ‘live well’.The IDEAL study was funded jointly by the Economic and Social Research Council (ESRC) and the National Institute for Health Research (NIHR) through grant ES/L001853/2. The ESRC is part of UK Research and Innovation (UKRI). ‘Improving the experience of Dementia and Enhancing Active Life: a longitudinal perspective on living well with dementia. The IDEAL-2 study’ was funded by the Alzheimer’s Society, grant number 348, AS-PR2-16-001

Perspectives of minority ethnic caregivers of people with dementia interviewed as part of the IDEAL programme

YesPostwar migrants from the Caribbean and Indian subcontinent (Bangladesh, India, and Pakistan) to the UK are now experiencing the onset of age-related diseases such as dementia. Our evidence base, both quantitative and qualitative, documenting the experiences of family caregivers of people with dementia is largely drawn from studies undertaken with white European, North American, and Australasian populations. Consequently, there is a need for research in the field of dementia caregiving to reflect the increasing diversity in ethnic identities of the older adult population of the UK. Using semistructured interviews, we investigated the experiences of 18 caregivers of people with dementia in Black Caribbean, Black African, and South Asian (Indian, Pakistani, and Bangladeshi) communities in England. Participants were recruited from the Join Dementia Research platform and were predominantly female intergenerational carers. We identified the following three themes: motivation to care (spending time with the care recipient and reciprocity), positive and negative consequences of caregiving (rewards and consequences), and the cultural context of caregiving (cultural norms and values supporting caregiving and negative attitudes towards dementia). Our findings develop existing literature by identifying (a) the importance of spending time with the person they care for, (b) the absence of faith as a caregiving driver, and (c) the challenge of watching the declining health of a parent. We highlight how the different motivations to care are intertwined and dynamic. This is illustrated by the linking of obligation and reciprocity in our dataset and positive and negative experiences of caregiving.Alzheimer's Society. Grant Numbers: 348, AS-PR2-16-001. National Institute for Health Researc

Living well with dementia: An exploratory matched analysis of minority ethnic and white people with dementia and carers participating in the IDEAL programme

YesThe increasing heterogeneity of the population of older people is reflected in an increasing number of people with dementia and carers drawn from minority ethnic groups. Data from the IDEAL study are used to compare indices of 'living well' among people with dementia and carers from ethnic minority groups with matched white peers. We used an exploratory cross-sectional case-control design to compare 'living well' for people with dementia and carers from minority ethnic and white groups. Measures for both groups were quality of life, life satisfaction, wellbeing, loneliness, and social isolation and, for carers, stress, relationship quality, role captivity and caring competence. The sample of people with dementia consisted of 20 minority ethnic and 60 white participants and for carers 15 and 45 respectively. People with dementia from minority ethnic groups had poorer quality of life (-4.74, 95% CI: -7.98 to -1.50) and higher loneliness (1.72, 95% CI: 0.78-2.66) whilst minority ethnic carers had higher stress (8.17, 95% CI: 1.72-14.63) and role captivity (2.00, 95% CI: 0.43-3.57) and lower relationship quality (-9.86, 95% CI: -14.24 to -5.48) than their white peers. Our exploratory study suggests that people with dementia from minority ethnic groups experience lower quality of life and carers experience higher stress and role captivity and lower relationship quality than their white peers. Confirmatory research with larger samples is required to facilitate analysis of the experiences of specific minority ethnic groups and examine the factors contributing to these disadvantages.Economic and Social Research Council. National Institute for Health and Care Research. Grant Number: ES/L001853/

Understanding dementia in minority ethnic communities: The perspectives of key stakeholders interviewed as part of the IDEAL programme

YesFuture populations of older adults in the UK, those aged 65+, will demonstrate increased diversity in terms of their ethnic identity resultant from the ageing of the post-war migrants from India, Pakistan, Bangladesh, and the Caribbean. As a consequence, there will be an increase in the numbers of older adults from these communities living with age-related chronic diseases such as dementia. In response to these demographic changes, we need to develop a research, policy and practice agenda that is inclusive and provides evidence for the development of culturally diverse and effective models of service delivery. This requires engagement with three key stakeholder groups: (a) people with dementia; (b) their carers; and (c) the wider community. As part of the IDEAL research programme on living well with dementia, we undertook semi-structured interviews with twelve community leaders, defined as known and trusted individuals active in their respective communities, and six community members (two people living with dementia and four carers). We explored their understandings, experiences, and views of about dementia. Our analysis identified two overarching themes. The migrant lifecourse highlighted issues of not belonging, discrimination and racism. This framed our second theme, the cultural context of dementia, which addressed dementia knowledge and attitudes, service provision and service access, and how being part of a minority ethnic community made a difference to these experiences. Our study highlights how lifecourse experiences of negative hostile social and policy environments and services can be profound and long-lasting and provide a prism through which accessing dementia care is experienced. Our findings argue for the inclusion of diverse views and lifecourse experiences within the context of developing a dementia strategy for research, policy and practice that is appropriate for a multicultural and heterogenous society.This work was supported by the Economic and Social Research Council, National Institute for Health and Care Research (ES/L001853/2), and Alzheimer’s Society (348, AS-PR2-16-001)